DIANE E WALLIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036061857

License Status

ACTIVE

Business

First Name

DIANE E

Last Name

WALLIS

Suffix

Business Name

DIANE E WALLIS MD

Original Issue Date

03/20/1981

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CARMEL

State

Zip

46033

Ever Disciplined

LastModifiedDate

11/16/2023